Carcinoma of the larynx, metastatic to illeum, presents as ruptured appendicitis: case report and literature review

  • Glicksman J
  • Bottoni D
  • Shepherd J
 et al. 
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Abstract

OBJECTIVES: Metastasis of laryngeal squamous cell carcinoma (SCC) to the intra-abdominal gastrointestinal tract is exceedingly rare. The objectives of this case report are to describe a case involving a perforated metastasis of a laryngeal SCC to the ileum and to review the literature pertaining to other similar cases.

METHODS: A review of patient's chart and a review of the English literature involving malignant SCC of the larynx with metastasis to the small bowel.

RESULTS: We describe the case of a 58-year-old man who had failed induction chemotherapy and underwent a laryngopharyngectomy with bilateral neck dissection and pectoralis major flap for a T4N2c laryngeal SCC. Subsequently, the patient was treated with postoperative radiation and cituximab.The patient went on to present with symptoms consistent with a ruptured appendix, supported by ultrasound imaging. The patient was taken to the operating room where a right hemicolectomy was performed. Pathological gross examination confirmed a 4 cm transmural perforation in the terminal ileum. Microscopy demonstrated deposits of metastatic squamous cell carcinoma in the surrounding smooth muscle. Metastatic carcinoma was also found in a separate nodule from the abdominal wall. The patient had an uncomplicated post-operative period, and survived several months thereafter.

CONCLUSIONS: Metastasis of laryngeal SCC to the small bowel with perforation is exceedingly rare, but possible. These patients may be successfully managed with resection.

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Authors

  • Jordan T. Glicksman

  • David Bottoni

  • Jessica Shepherd

  • Neil Parry

  • Jason H. Franklin

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